compliance question

[neallo]

Ok,I went to my sleep doctor today. he said every thing is fine. See you in a year. Well, my question is how will I meet compliancy with my insurance if I don't take my machine back to be downloaded. Also, why did my DME say I have a 10 month rental when I hit my cpap 6 weeks ago, but the paper work I got from my insurance this week said I have a 4 month rental period?

[robysue]

Ok,I went to my sleep doctor today. he said every thing is fine. See you in a year. Well, my question is how will I meet compliancy with my insurance if I don't take my machine back to be downloaded.

The DME who sold you (and your insurance company) the machine will be the one who provides compliance data (how many hours you use the machine) to the insurance company so that they'll be paid. Most insurance companies only demand one or two compliance downloads: If you're using the machine enough to satisfy the insurance company at the end of 30 and 60 days, they'll continue paying their share of the rent-to-own agreement; if not, they'll deny coverage and the DME will demand you either return the machine or pay the whole bill yourself.

Also, why did my DME say I have a 10 month rental when I hit my cpap 6 weeks ago, but the paper work I got from my insurance this week said I have a 4 month rental period?

You need to straighten this out. Paperwork snafus and DME misstatements about the actual coverage are pretty common place. My suggestions:

1) Call the insurance company to confirm the terms in the letter are correct.

2) Call the DME and let them know about the letter. Bring a copy of the letter off at the DME and ask them to tell you what they think is going on. They'll probably need a copy of the letter and a bit of time to sort out the paperwork and get back to you. If they ask for the letter, make sure you are giving them a copy of the letter---do NOT give them the one and only copy of the letter that you have.

[neallo]

Thanks for the post. It just threw me for a loop to go to my sleep doc told everything looks good machine is doing it's job and I will see you in a year. And that was my whole doctor visit. I was thinking I would continually have to go to the dme and have my compliance checked every so often, but ess told I was good. So now I just sit and take time too get fully used to the machine. Hopefully in June or July resmed will have s new ffm out which goes under the chin. S guy can hope for something new. My dme didn't have an under chin ffm yet, Orr do they and I was told that my store doesn't have one??? Anyone working with sleepmed know if they carry one or not.?

I think I will just wait and see what happens, because 1 when I call the insurance co I sit on hold for upto an hour and I am just not upto it right now as I had a frustrating battle with them over me moving outta state butt still working on their coverage area. The dme probably told me right because I am thinking my insurance company is doing a four month thingy and then a three month one and then finally another three month one. Wow an I being wordy today

[Julie]

Have you looked at the Forma mask - it goes under the chin.

[HerbM]

Caveat: I am new to this too.

My doc said at the first visit that he only sees most patience once per year (seemed sort of weird to me when he said it.)

Up to that point I was investigating changing to him for my heart care since he is also a cardiologist. (I like my current cardiologist but even though she has OSA posters in all the treatment rooms she was surprised that my DENTIST caught my OSA and she had been seeing me 1 1/2 years.)

I don't think she was negligent or anything -- in my case most of the "discomfort" symptoms are missing. To my knowledge there is no unusual (or at least unexpected) tiredness, confusion, headaches, unexpected/unintentional sleep, etc.

My wife says I snore (but we don't have any independent confirmation of that ) and my health issues involve things known to be aggravated by OSA: hypertension, cardiomyopathy (both treated well with meds)...

Given that a quick PulseOx home test (the Dentist offered me this) is a CHEAP and EASY way to get a good indication of whether a full sleep study is warranted it would seem the docs should be well advised to do more of these.

I digressed.

Point is the sleep doc wants me back after 3 weeks on machine, and once he gets me stabilized probably won't see me for a year unless *I* call him.

The DME will see me in about 90 days to read the SD card for compliance I believe.

[archangle]

It's quite common for CPAP machines to come with a cellular modem that will automatically report data back to the DME.

You can also send in just the SD card, or the DME can also call you, have you push some buttons and tell them the numbers to prove your compliance. There is even a checksum to verify you read him the real numbers.

Many people also find that their insurance never really checks their compliance.

Your S9 machine keeps compliance information for a full year stored on the machine.